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Study of clinical features of amyloid angiopathy hemorrhage and hypertensive intracerebral hemorrhage
作者姓名:詹仁雅  童鹰  沈剑峰  LANG E.  PREUL C.  HEMPELMANN R.G.  HUGO H.H.  BUHL R.  BARTH H.  KLINGE H.  MEHDORN H.M
作者单位:Department of Neurosurgery,First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,China,Department of Neurosurgery,First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,China,Department of Neurosurgery,First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,China,Department of Neurosurgery,Kiel University,Kiel D-24106,Germany,Department of Neurosurgery,Kiel University,Kiel D-24106,Germany,Department of Neurosurgery,Kiel University,Kiel D-24106,Germany,Department of Neurosurgery,Kiel University,Kiel D-24106,Germany,Department of Neurosurgery,Kiel University,Kiel D-24106,Germany,Department of Neurosurgery,Kiel University,Kiel D-24106,Germany,Department of Neurosurgery,Kiel University,Kiel D-24106,Germany,Department of Neurosurgery,Kiel University,Kiel D-24106,Germany
摘    要:Objective: The purpose of this study was to differentiate between cerebral amyloid angiopathy (CAA) and hypertension (HTN) based on hemorrhage pattern interpretation. Methods: From June 1994 to Oct., 2000, 83 patients admitted to our service with acute intracerebral hemorrhage (ICH) were investigated retrospectively; 41 patients with his-tologically proven diagnosis of cerebral amyloid angiography and 42 patients with clear history of hypertension were investigated. Results: Patients with a CAA-related ICH were significantly older than patients with a HTN-related ICH (74.0 years vs 66.5 years, P<0.05). There was a significantly higher number of hematomas>30 ml in CAA (85.3%) when compared with HTN (59.5%). No basal ganglional hemorrhage was seen in CAA, but in 40.5% in HTN. In CAA-related ICH, su-barachnoid hemorrhage (SAH) was seen in 26 patients (63.4%) compared to only 11 patients (26.2%) in HTN-related ICH. Intraventricular hemorrhage was seen in 24.4% in CAA, and in 26.2% in HTN. Typical features o


Study of clinical features of amyloid angiopathy hemorrhage and hypertensive intracerebral hemorrhage
ZHANRen-ya,TONG Ying,SHEN Jian-feng,LANG E.,PREUL C.,HEMPELMANN R.G.,HUGO H.H.,BUHL R.,BARTH H.,KLINGE H.,MEHDORN H.M..Study of clinical features of amyloid angiopathy hemorrhage and hypertensive intracerebral hemorrhage[J].Journal of Zhejiang University Science,2004(10).
Authors:ZHANRen-ya  TONG Ying  SHEN Jian-feng  LANG E  PREUL C  HEMPELMANN RG  HUGO HH  BUHL R  BARTH H  KLINGE H  MEHDORN HM
Abstract:Objective: The purpose of this study was to differentiate between cerebral amyloid angiopathy (CAA) and hypertension (HTN) based on hemorrhage pattern interpretation. Methods: From June 1994 to Oct., 2000, 83 patients admitted to our service with acute intracerebral hemorrhage (ICH) were investigated retrospectively; 41 patients with his-tologically proven diagnosis of cerebral amyloid angiography and 42 patients with clear history of hypertension were investigated. Results: Patients with a CAA-related ICH were significantly older than patients with a HTN-related ICH (74.0 years vs 66.5 years, P<0.05). There was a significantly higher number of hematomas> ml in CAA (85.3%) when compared with HTN (59.5%). No basal ganglional hemorrhage was seen in CAA, but in 40.5% in HTN. In CAA-related ICH, su-barachnoid hemorrhage (SAH) was seen in 26 patients (63.4%) compared to only 11 patients (26.2%) in HTN-related ICH. Intraventricular hemorrhage was seen in 24.4% in CAA, and in 26.2% in HTN. Typical features of CAA-related ICH included lobar distribution affecting mainly the lobar superficial areas, lobulated appearance, rupture into the subarachnoid space, and secondary IVH from the lobar hemorrhage. More specifically, multiplicity of hemorrhage, bilaterality, and repeated episodes also strongly suggest the diagnosis of CAA. Multiple hemorrhages, defined as 2 or more separate he-matomas in multiple lobes, accounted for 17.1% in CAA-related ICH. Conclusion: There are certain features in CAA on CT and MRI and in clinical settings. To some extent, these features may contribute to distinguishing CAA from HTN related ICH.
Keywords:Intracerebral hemorrhage  Cerebral amyloid angiopathy  Hypertension  Diagnosis  Computed tomography  Magnetic resonance imaging
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